Diode and the Asia School of Business jointly applied for an Epidemic Ethics WHO Grant, in which we were successful and proceeded to conduct Project ECCO, a project that explored ethical challenges faced by vulnerable communities and service providers during the COVID-19 pandemic.

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Why this study? 

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Globally, COVID-19 has exposed how vulnerable populations are disproportionately affected by the outbreak and the responses to the outbreak. In Malaysia, approximately twenty percent of total cases  were confirmed among non-citizens, a known vulnerable population within the country. Indigenous people are also found to be more vulnerable to the pandemic due to the limited access to timely healthcare services in rural areas.

 

Numerous ethical challenges have arisen; intersecting ethical problems from managing a contagious disease of high morbidity with allocation of scarce resources and addressing the longer term social and economic impact. Vulnerable populations are most impacted by these ethical challenges due to pre-existing barriers to access to healthcare, immigration status, and underlying health conditions.

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What does Project ECCO aim to do?

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​This study will explore the impact of the COVID-19 outbreak on vulnerable populations, namely populations on the move, and Indigenous populations, through an ethical lens, with an aim to provide recommendations and educational tools to improve protective policies in future crises. Using an approach that combines the consequentialist ethical framework and public health ethical principles, the study combines a desk review with a set of in-depth interviews with members of vulnerable communities, humanitarian agencies, and employers.

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What are some conclusions and recommendations from the Project? 

The project has completed data collection and analysis, and the team has had the first paper published. The following are some key conclusions and recommendations: 

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1. There is a need for stronger ethical practices by government agencies and aid providers, that are rooted in human rights. 

• The co-occurrence of non-beneficence and maleficence highlights the gap in knowledge and skills amongst aid providers, in terms of ethical practices or standards in providing aid to vulnerable populations.

• This gap can cause more harm to the beneficiaries as these unethical, dehumanizing practices are usually underreported and brushed aside, since the beneficiaries have less social capital than the aid providers. 

 

2. Increasing unrestricted funding directly to humanitarian aid providers is key to enabling better ethical practices.

• Increasing the amount of unrestricted, private donations directly to aid providers is a more efficient mechanism than donating funds through larger channels as small, grassroots NGOs or community led organizations have closer connections and access to vulnerable populations and are able to ensure they receive aid indiscriminately. 

• There is a need for corporations and private donors to review and re-examine their practices and roles, which may inflict harm on vulnerable populations despite their well-placed intentions. 

 

3. Worrying trends and behaviors of agents of harm (e.g., aid providers, the police, the healthcare system) suggest the overdue need for significant institutional reforms of the provision of aid and the treatment of vulnerable populations.

• Discriminatory welfare policies.

• Increasing harassment and dehumanizing treatment by enforcement authorities. 

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Current Project Status

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Diode is currently working on dissemination of results and using the data generated to create tools to support service providers in future humanitarian crises. Specifically these tools are:

(1) an ethical matrix to support ethical programming for vulnerable populations and

(2) An algorithm to guide an approach to intersectional vulnerabilities.

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A dissemination workshop on the findings and piloting of the ethical matrix was conducted in August 2022.We are currently refining the tool based on feedback from the workshop participants. Further infographics and other materials are also being developed to disseminate findings from the research. 

 

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